Spontaneous Transvaginal Small Bowel Evisceration in a Postmenopausal Women

Spontaneous evisceration through the vagina was first described in 1907 by McGregor.1 To date, only eighty-five cases of transvaginal small bowel evisceration have been documented worldwide.1, 2 The primary risk groups for spontaneous vaginal evisceration include postmenopausal women, 1, 37 vaginal surgery cases, 1, 810 multiparae, 11 and women of older age.2, 3 In postmenopausal woman, transvaginal evisceration is frequently associated with increased abdominal pressure, 1 vaginal ulceration due to severe atrophy, and straining at stool.6, 8 Vaginal evisceration is a medical emergency that requires prompt recognition and immediate surgical intervention.1 The associated mortality rate is 5.6 percent, however, the incidence of morbidity is higher3, 8 when the bowel has become strangulated through the vaginal defect. Here, we report a case of Spontaneous transvaginal small bowel evisceration in a postmenopausal women and highlight the risk factors, clinical presentation, and treatment options for this rare gynaecological emergency.